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Individual

ELLIOT ANTHONY NACKE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
1305 JENNINGS MILL RD STE 110, WATKINSVILLE, GA 30677-7241
(706) 613-5880
Mailing address
1305 JENNINGS MILL RD STE 110, WATKINSVILLE, GA 30677-7241

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
90210
GA
207XS0106X
Orthopaedic Hand Surgery Physician
036135852
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
036135852
IL
Enumeration date
04/23/2008
Last updated
01/04/2022
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